The Strange Case of Phineas Gage

In 1848, an accident injured a 25-year-old railroad worker named Phineas Gage. It was thought he was never the same again, but he may have just been the survivor of a horrific accident.

Phineas Gage was part of a railroad crew excavating rocks for a new railway bed in Cavendish, Vermont, on a fateful day in September 1848. As he was using a tamping iron to pack explosives into a borehole, something terrible happened. The explosive powder detonated and sent the 13.25 pound, 43-inch-long tamping iron straight into Gage’s face. The rod, which was more than an inch in diameter, entered his left cheek, went through his brain, and exited the back of his skull. His left eye was destroyed, but he somehow survived. The rod was reportedly found 32 feet away.

Gage was attended to at the scene by Dr. John Harlow. It was reported that Gage was conscious and even able to walk. Harlow began to take care of Gage back where he lived. The doctor removed small bone fragments and replaced the larger pieces of bone before closing the wounds caused by the iron rod. Gage recovered even after healing from an infected wound and after apparent damage to the left frontal lobe of the brain. But Harlow began to observe that there had been a change in Gage’s personality. His friends also reportedly said that Gage “was no longer Gage.”

Path of the rod according to Harlow

It was said that Gage had become violent, uninhibited, or didn’t behave appropriately socially, and this was different than the way he had been before. The problem with this is that the evidence for this change is scant. Not much is known about Gage before he had his accident and not much is known about what he did after the accident. Much of the information that was spread came from Harlow’s observations or possibly inflated reports thereafter. It was, in fact, a sensational story of survival.

According to psychologist Malcolm Macmillan, who wrote An Odd Kind of Fame: Stories of Phineas Gage, Gage’s personality most likely did change but maybe for only two to three years. Much of what was reported about Gage’s change could be mostly scientific myth.

After the accident Gage was not allowed back to work at the railroad. He went to New Hampshire to work in a stable, and then drove stagecoaches in Chile, a complex job that probably wouldn’t have been able to be done based on earlier reports about the change in his personality and behavior. Gage later settled in San Francisco with his mother and sister in 1859. He died in 1860 from an epileptic seizure, possibly due to his brain injury in 1848. Gage’s skull and the rod that caused his injury are on display at Harvard’s Warren Anatomical Museum.

Gage’s case spurred the discussion about personality and the brain, and how the brain can possibly recover and adapt to such a trauma. Two things are certain, however. It is amazing that Gauge could survive and function after such an accident, and his case changed the field of neuroscience forever.